Maternal anaemia and maternal, fetal, and neonatal outcomes in a prospective cohort study in India and Pakistan

IntroductionHepcidin production is normally upregulated by iron stores, and in obesity has been shown to be overexpressed and correlated with low iron status. The increased hepcidin may restrain the iron release from the cells by affecting the expression of ferroportin, which probably associates with the development of diabetes complication. First, we investigate the difference of serum hepcidin and iron parameters between obese and non-obese pregnant women; second, we examine the correlation between serum hepcidin and adverse maternal and neonatal outcomes in pregnant women.Methods and analysisThis is a mono-centre, prospective cohort study with a study (obese) and a control group (non-obese women). In the first trimester, 188 singleton pregnancies will be recruited. Thereof, we expect 75 with a body mass index (BMI) ≥30 kg/m2and 113 with a BMI 18.5–30 kg/m2. Serum hepcidin, iron and haematological parameters will be measured at 11–14, 24–28, 32–36 weeks of gestation and at time of delivery. Blood pressure, weight, BMI and smoking status will be examined at all visits. We will assess the composite endpoints adverse maternal outcomes (including pre-eclampsia, gestational hypertension, gestational diabetes mellitus, haemorrhage, placenta abruption) and adverse neonatal outcomes (preterm birth, intrauterine growth restriction, preterm premature rupture of membranes, Apgar score <7 at 5 min, stillbirth, neonatal death).Recruitment has started in April 2019.Ethics and disseminationThis study received ethical approval from the ethics committee in Basel. The results of the study will be published in a peer-reviewed journal, and presented at national scientific conferences.Trial registration numberNCT03792464.

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Maternal vitamin D deficiency increases the risk of adverse neonatal outcomes in the Chinese population: A prospective cohort study

PLoS ONE ◽

10.1371/journal.pone.0195700 ◽

2018 ◽

Vol 13 (4) ◽

pp. e0195700 ◽

Cited By ~ 11

Author(s):

Yuanliu Wang ◽

Honghui Li ◽

Min Zheng ◽

Yubi Wu ◽

Ting Zeng ◽

...

Keyword(s):

Vitamin D ◽

Cohort Study ◽

Vitamin D Deficiency ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Chinese Population ◽

Neonatal Outcomes ◽

Maternal Vitamin ◽

Adverse Neonatal Outcomes

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The association of maternal age with adverse neonatal outcomes in Lusaka, Zambia: a prospective cohort study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03361-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Tannia Tembo ◽

Aybüke Koyuncu ◽

Haoran Zhuo ◽

Martha Mwendafilumba ◽

Albert Manasyan

Keyword(s):

Clinical Trial ◽

Cohort Study ◽

Health Outcomes ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Maternal Age ◽

Health Facilities ◽

Neonatal Outcomes ◽

Trial Registration ◽

Adverse Neonatal Outcomes

Abstract Background Pregnancy among adolescents, whether intended or not, is a public health concern as it is generally considered high risk for both mothers and their newborns. In Zambia, where many women engage in early sexual behaviour or marry at a young age, 28.5% of girls aged 15–19 years were pregnant with their first child in the year 2013–2014. This study sought to explore associations between maternal age and neonatal outcomes among pregnant women in Lusaka, Zambia. Methods This was a secondary analysis of data nested within a larger population-based prospective cohort study which was implemented in three government health facilities-two first level hospitals and one clinic in Lusaka, Zambia. Women presenting to the study sites for antenatal care were enrolled into the study and followed up for collection of maternal and neonatal outcomes at 7, 28 and 42 days postpartum. The study’s primary outcomes were the incidence of maternal and newborn complications and factors associated with adverse neonatal outcomes. Statistical significance was evaluated at a significance level of P < 0.05. Results The study included 11,501 women, 15.6% of whom were adolescents aged 10–19 years. Generally, adolescence did not have statistically significant associations with poor maternal health outcomes. However, the risk of experiencing obstructed labour, premature rupture of membranes and postpartum hemorrhage was higher among adolescents than women aged 20–24 years while the risk of severe infection was lower and non-significant. Adolescents also had 1.36 times the odds of having a low birthweight baby (95% CI 1.12, 1.66) and were at risk of preterm birth (aOR = 1.40, 95% CI 1.06, 1.84). Their newborns were in need of bag and mask resuscitation at birth (aOR = 0.62, 95% CI 0.41, 0.93). Advanced maternal age was significantly associated with increased odds of hypertension/ pre-eclampsia (95% CI 1.54, 5.89) and preterm labour (aOR = 2.78, 95% CI 1.24, 6.21). Conclusions Adolescence is a risk factor for selected pregnancy outcomes in urban health facilities in Lusaka, Zambia. Health care workers should intensify the provision of targeted services to improve neonatal health outcomes. Trial registration Clinical trial number and URL: NCT03923023 (Retrospectively registered). Clinical trial registration date: April 22, 2019.

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Components of the antepartum, intrapartum, and postpartum exposome impact on distinct short-term adverse neonatal outcomes of premature infants: A prospective cohort study

PLoS ONE ◽

10.1371/journal.pone.0207298 ◽

2018 ◽

Vol 13 (12) ◽

pp. e0207298 ◽

Cited By ~ 7

Author(s):

Unzila Ali Nayeri ◽

Catalin S. Buhimschi ◽

Guomao Zhao ◽

Irina A. Buhimschi ◽

Vineet Bhandari

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Premature Infants ◽

Prospective Cohort ◽

Neonatal Outcomes ◽

Short Term ◽

Adverse Neonatal Outcomes

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Hypercoiling of the umbilical cord in uncomplicated singleton pregnancies

Journal of Perinatal Medicine ◽

10.1515/jpm-2017-0034 ◽

2018 ◽

Vol 46 (6) ◽

pp. 593-598 ◽

Cited By ~ 4

Author(s):

Marwan Ma’ayeh ◽

Evan McClennen ◽

Dmitri Chamchad ◽

Michael Geary ◽

Norman Brest ◽

...

Keyword(s):

Cohort Study ◽

Umbilical Cord ◽

Prospective Cohort Study ◽

Strong Correlation ◽

Prospective Cohort ◽

Neonatal Outcomes ◽

Secondary Outcome ◽

Second Trimester ◽

Umbilical Coiling Index ◽

Singleton Pregnancies

Abstract Background: The umbilical coiling index (UCI) is a measure of the number of coils in the umbilical cord in relation to its length. Hypercoiled cords with a UCI of >0.3 coils/cm have been associated with adverse fetal and neonatal outcomes. Aims: The primary aim is to determine the accuracy of UCI measured on second trimester ultrasound in predicting UCI at birth. The secondary outcome is to investigate the association between hypercoiling of the umbilical cord on prenatal ultrasound and adverse maternal, fetal and neonatal outcomes. Methods: This was a prospective cohort study of uncomplicated singleton pregnancies. Seventy two patients were included in the study. UCI was measured in the second trimester ultrasound, and compared to UCI measured postnatally. Outcomes of patients with hypercoiled cords on ultrasound were compared to outcomes of patients with normocoiled cords. Results: Our results failed to show a strong correlation between the UCI determined with ultrasound, and the UCI determined with examination of the umbilical cord after delivery. We also did not demonstrate that measurement of the UCI on second trimester ultrasound is able to predict adverse maternal, fetal or neonatal outcomes. Conclusion: This study suggests that measurement of the umbilical coiling index should not be part of routine second trimester sonography in patients with uncomplicated singleton pregnancies, with no other medical or surgical comorbidities.

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Fetal and Perinatal Outcome Following First and Second Trimester COVID-19 Infection: Evidence from a Prospective Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm10102152 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2152

Author(s):

Hadar Rosen ◽

Yossi Bart ◽

Rita Zlatkin ◽

Liat Ben-Sira ◽

Dafna Ben Bashat ◽

...

Keyword(s):

Cohort Study ◽

Vertical Transmission ◽

Prospective Cohort Study ◽

Gestational Age ◽

Prospective Cohort ◽

Perinatal Outcomes ◽

Neonatal Outcomes ◽

Second Trimester ◽

Early Gestation ◽

The Mean

A novel coronavirus termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new strain of coronavirus causing coronavirus disease 2019 (COVID-19) disease, which emerged as a global pandemic. Data regarding the implications of COVID-19 disease at early gestation on fetal and obstetric outcomes is scarce. Thus, our aim was to investigate the effect of first and second trimester maternal COVID-19 disease on fetal and perinatal outcomes. This was a prospective cohort study of pregnant women with a laboratory-proven SARS-COV-2 infection contracted prior to 26 weeks gestation. Women were followed at a single tertiary medical center by serial sonographic examinations every 4–6 weeks to assess fetal well-being, growth, placental function, anatomic evaluation and signs of fetal infection. Amniocentesis was offered to assess amniotic fluid SARS-COV-2-PCR (polymerase chain reaction) and fetal brain magnetic resonance imaging (MRI) was offered at 30–32 weeks gestation. Demographic, obstetric and neonatal data were collected from history intake, medical charts or by telephone survey. Perinatal outcomes were compared between women infected at first vs. second trimester. 55 women with documented COVID-19 disease at early gestation were included and followed at our center. The mean maternal age was 29.6 ± 6.2 years and the mean gestational age at viral infection was 14.2 ± 6.7 weeks with 28 (51%) women infected at the first trimester and 27 (49%) at the second trimester. All patients but one experienced asymptomatic to mild symptoms. Of 22 patients who underwent amniocentesis, none had evidence of vertical transmission. None of the fetuses exhibited signs of central nervous system (CNS) disease, growth restriction and placental dysfunction on serial ultrasound examinations and fetal MRI. Pregnancies resulted in perinatal survival of 100% to date with mean gestational age at delivery of 38.6 ± 3.0 weeks and preterm birth <37 weeks rate of 3.4%. The mean birthweight was 3260 ± 411 g with no cases of small for gestational age infants. The obstetric and neonatal outcomes were similar among first vs. second trimester infection groups. We conclude SARS-CoV-2 infection at early gestation was not associated with vertical transmission and resulted in favorable obstetric and neonatal outcomes.

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